According to a study published online ahead of print in the journal Diabetes, Obesity and Metabolism, researchers have found that risk of heart attack or stroke is similar for treatment with sulfonylureas or insulin, plus metformin, among patients with type 2 diabetes.
For the study, researchers evaluated the risk of heart attack and stroke associated with sulfonylureas plus metformin and insulin plus metformin. Results showed that the risk of heart attack or stroke was similar in both groups.
"Current evidence suggests that there may not be large differences in cardiovascular risk associated with the use of insulin or sulfonylureas when used in combination with metformin," the authors concluded.
A study published last year in the Journal of the American Medical Association found that adding a sulfonylurea, rather than insulin, to metformin should be preferred in patients requiring a second antidiabetes medication. The study demonstrated that metformin plus insulin was decrease survival, but other experts questioned those results.
For patients with type 2 diabetes, the risk of myocardial infarction or stroke is similar for treatment with insulin or sulfonylureas in combination with metformin.